Call to Order and Roll Call
The fifth meeting of the Interim Joint Committee on Health and Welfare was held on Wednesday, October 16, 2013, at 1:00 p.m., in Room 129 of the Capitol Annex. Representative Tom Burch, Co-Chair, called the meeting to order at 1:05 p.m., and the secretary called the roll.
Present were:
Members: Senator Julie Denton, Co-Chair; Representative Tom Burch, Co-Chair; Senators Joe Bowen, Tom Buford, Julian M. Carroll, Perry B. Clark, David P. Givens, Denise Harper Angel, Alice Forgy Kerr, and Katie Stine; Representatives Julie Raque Adams, Robert Benvenuti III, Bob M. DeWeese, Joni L. Jenkins, Mary Lou Marzian, Tim Moore, Darryl T. Owens, Ruth Ann Palumbo, David Watkins, Russell Webber, Susan Westrom, and Addia Wuchner.
Guests: Polly Mullins-Bentley, RN, RHIT, State Health I.T. Coordinator, Acting Executive Director, Governor’s Office of Electronic Health Information, Cabinet for Health and Family Services; Dr. John Langefeld, Chief Medical Officer, Department for Medicaid Services, Cabinet for Health and Family Services; Dr. Stephanie Mayfield, Commissioner, Department for Public Health, Cabinet for Health and Family Services; Dr. Allen Brenzel, Clinical Director, Deputy Commissioner, Department for Behavioral Health, Developmental and Intellectual Disabilities, Cabinet for Health and Family Services; Karen Chrisman, staff attorney for the Governor’s Office of Health Information Exchange; Elizabeth Whitehouse, Deputy Executive Director, Governor's Office of Early Childhood; Brigitte Blom Ramsey, Kentucky Early Childhood Advisory Council and United Way of Greater Cincinnati/Northern Kentucky; Larry Coffee, DDS, Founder and CEO, Dental Lifeline Network; Stewart Perry, State Advocacy Volunteer Chair, American Diabetes Association; Pam Hagan, APRN/Practice & Education Consultant, Paula Schenk, Executive Director, and Nathan Goldman, General Counsel, Kentucky Board of Nursing; Tamara Sandberg, Executive Director, Kentucky Association of Food Banks; Paula Goff, Julie Brooks, and Fran Hawkins, Department for Public Health, Cabinet for Health and Family Services; Gary Miles, Feeding America, Kentucky Heartland; Marty White, Capital Link Consultants; Bob Babbage representing the American Diabetes Association; Lori Bradley, mother; Michael Rodman, Kentucky Board of Medical Licensure; Joel Griffith, Prevent Child Abuse Kentucky; Priscilla Black, Legislative Research Commissioner; Sarah S. Nicholson, Kentucky Hospital Association; and David Adams, KCJ.
LRC Staff: DeeAnn Wenk, Ben Payne, Jonathan Scott, Sarah Kidder, Gina Rigsby, and Wesley Whistle.
Minutes
A motion to approve the minutes of the September 18, 2013 meeting was made by Representative Marzian, seconded by Representative Watkins, and approved by voice vote.
Consideration of Referred Administrative Regulations
The following administrative regulations were available for consideration: 201 KAR 9:016 – establishes the requirements governing the use of amphetamine and amphetamine-like anorectic controlled substances; 201 KAR 17:012 – establishes criteria for licensure for speech-language pathologists; 201 KAR 17:030 – establishes the required fees and the requirements for inactive status for a speech-language pathologist, speech-language pathology assistant, or audiologist; 201 KAR 17:034 – establishes criteria for licensure for speech-language pathology assistants; 201 KAR 17:036 – establishes requirements for licensure for an audiologist; 902 KAR 18:011 – establishes definitions for the definitions for the Kentucky Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) found in 902 KAR Chapter 18; 902 KAR 18:021 – establishes the application and participation process for participants of the Kentucky Special Supplemental Nutrition Program for Women, Infants, and Children (WIC); 902 KAR 18:031 – establishes the sanction schedule for participant abuse of the Kentucky Special Supplemental Nutrition Program for Women, Infants, and Children (WIC); 902 KAR 18:040 – establishes the fair hearing procedures for participants for the Kentucky Special Supplemental Nutrition Program for Women, Infants, and Children (WIC); 902 KAR 18:050 – establishes the vendor authorization criteria for the Kentucky Special Supplemental Nutrition Program for Women, Infants, and Children (WIC); 902 KAR 18:061 – establishes the vendor violations and sanctions for the Kentucky Special Supplemental Nutrition Program for Women, Infants, and Children (WIC); 902 KAR 18:071 – establishes procedures for Kentucky Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) vendor disqualification including the participant access determination and civil money penalty; 902 KAR 18:081 – establishes the local agency’s and vendor’s rights to a hearing in regards to the Kentucky Special Supplemental Nutrition Program for Women, Infants, and Children (WIC); 902 KAR 18:090 – establishes the high risk criteria for contracted retailers with the Kentucky Special Supplemental Nutrition Program for Women, Infants, and Children (WIC); 902 KAR 30:001 – establishes the definitions for 902 KAR Chapter 30 pertaining to First Steps, Kentucky’s Early Intervention Program; 902 KAR 30:110 – establishes the point of entry and service coordination provisions pertaining to First Steps, Kentucky’s Early Intervention Program; 902 KAR 30:120 – establishes the evaluation, eligibility, and redetermination of eligibility requirements for First Steps, Kentucky’s Early Intervention Program; 902 KAR 30:130 – establishes the requirements for assessment, the Individualized Family Services Plans used in First Steps, and assistive technology; 902 KAR 30:150 – establishes the provider qualifications for participation in First Steps, Kentucky’s Early Intervention Program; 902 KAR 30:160 – establishes the provisions of covered services under First Steps, Kentucky’s Early Intervention Program; 902 KAR 30:180 – establishes the procedural safeguards for facilities participating in First Steps, Kentucky’s Early Intervention Program; 902 KAR 30:200 – establishes the provisions relating to early intervention services for which payment shall be made on behalf of eligible recipients; 921 KAR 2:040 – establishes the procedures used to determine initial and continuing eligibility for assistance under the Kentucky Transitional Assistance Program (K-TAP) and the State Supplementation Program (SSP); 921 KAR 2:046 – establishes the conditions under which an application is denied or assistance is decreased or discontinued and advance notice requirements; 921 KAR 2:050 – establishes the time and manner of State Supplementation Program (SSP) payments and Mental Illness or Mental Retardation (MIMR) Supplement Program payments; and 922 KAR 1:450 – establishes a procedure for administrative hearings and criteria pertaining to the release of foster or adoption status information. A motion to accept the referred administrative regulations was made by Representative Owens, seconded by Representative Marzian, and accepted by voice vote.
Update on the Kentucky Health Information Exchange
Polly Mullins-Bentley, RN, RHIT, State Health I.T. Coordinator, Acting Executive Director, Governor’s Office of Electronic Health Information, Cabinet for Health and Family Services, stated that in 2005, Senate Bill 2 created a secure interoperable statewide electronic health network, established the Kentucky eHealth Network Board (KeHN), and appointed the Health Information Exchange committee. In 2007, the cabinet received a $4.9 million Medicaid Transformation Grant that provided funds to build the technical infrastructure for the KHIE. In 2009, the Cabinet for Health and Family Services received $9.75 million in ARRA/HITECH funding that provided Kentucky the advantage in progressing towards statewide health information exchange. Fifty-six states and territories were awarded $548 million in federal funds for a state health information exchange (HIE) cooperative agreement. The purpose of the agreement was to rapidly build capacity for exchange of health information across the health care system both within and across states. In August 2009, Governor Beshear issued an executive order establishing the Governor’s Office of Electronic Health Information within the Cabinet for Health and Family Services to oversee the advancement of health information exchange in Kentucky.
Dr. Stephanie Mayfield, Commissioner, Department for Public Health, Cabinet for Health and Family Services, stated that there are 507 KHIE live connections in hospitals, physician offices, and laboratories. KHIE provides a common, secure electronic information infrastructure that meets national standards to ensure interoperability across various health systems. KHIE affords healthcare providers the functionality to support preventive health and disease management through alters, messaging, and other tools. The Veterans Administration was one of the first to use electronic health records.
Dr. John Langefeld, Chief Medical Officer, Department for Medicaid Services, Cabinet for Health and Family Services, stated that health information technology can improve a patient’s experience of care, increase the overall health of populations, address behavioral risk factors, focus on preventive care, and lower the total cost of care while improving quality resulting in reduced monthly expenditures for Medicare, Medicaid, and CHIP beneficiaries.
Dr. Allen Brenzel, Clinical Director, Deputy Commissioner, Department for Behavioral Health, Developmental and Intellectual Disabilities, Cabinet for Health and Family Services, stated that people with mental illness die earlier than the general population and have more co-occurring health conditions. Sixty-eight percent of adults with a mental illness have one or more chronic physical conditions. Approximately one in five adults with mental illness has a co-occurring substance use disorder. The current system leads to lack of coordination of physical and behavioral health care. Behavioral health providers were left out of federal incentives to build electronic health records. Confidentiality requirements represent challenges especially around substance abuse treatment. The solution lies in integrated care, coordination of mental health, substance abuse, and primary care services. Integrated care produces the best outcomes and is the most effective approach to caring for people with complex healthcare needs. Patient-centered medical homes require data systems integration.
In response to questions by Representative Moore, Dr. Langefeld stated that data that flows through the KHIE comes from Medicaid recipients, electronic health records from participating providers, and laboratory data. The data is kept within the Cabinet for Health and Family Services. Ms. Bentley stated that the KHIE is a query-based federated model and there is no data repository. KHIE has a participation agreement with every participating provider. Provider data is HIPAA compliant. The participation agreement states the information is for treatment, payment, and operation under HIPAA. Karen Chrisman, staff attorney for the Governor’s Office of Health Information Exchange, stated the only people who are provisioned into the HIE are healthcare providers or state employees provisioned for a specific use.
In response to questions by Senator Carroll, Dr. Brenzel stated that there is a lot of duplication of tests and medications because doctors do not have access to all of a patient’s records since not all providers participate in KHIE. It could be detrimental if behavioral health information is not included in the KHIE. Dr. Mayfield stated that it costs her laboratory approximately $6,000 per year in maintenance costs to participate in KHIE. If a average size, single practice provider who does not have electronic health records, it could costs between $3,000 to $5,000 to install the electronic records, and the monthly maintenance fee for a basic system could cost between $1,000 to $3,000. Senator Carroll suggested that all doctors should be mandated to participate in the KHIE in order to be able to have access to all of a patient’s medical information at all times.
In response to questions by Representative Wuchner, Ms. Bentley stated that when a provider receives federal incentive dollars, it has adopted an electronic medical record and is pursuing meaningful use of electronic technology to improve patient care. To date in Kentucky Medicaid and Medicare receive approximately $3 million incentive dollars. Medicare incentives come straight from the Centers for Medicare and Medicaid Services (CMS) and go directly to providers. Medicaid receives approximately $140 million pass-through incentive dollars from CMS that goes to providers. KHIE is interfaced with EPIC, Meditech, and CPSI and work with over 80 electronic medical record vendors. Warnings are included in KHIE that deters a provider from accessing medical information on someone who is not the provider’s patient. Dr. Mayfield stated that providers will have to submit the patient quality reporting systems and meaningful use data electronically in order to get advanced reimbursement. Dr. Brenzel stated that the goal is to have patient portals to allow patients access to their own medical records to correct any wrong data or update personal information if necessary.
In response to questions by Representative Benvenuti, Ms. Bentley stated that KHIE has the ability to audit providers. A patient is able to ask who has accessed his or her medical records from KHIE, but is encouraged to ask the provider first. The cabinet is a government entity and maintains all government-required levels for security. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) has exceptions for law enforcement to access a person’s medical records, but in Kentucky, the information would have to come directly from the provider not KHIE. KHIE has never received a subpoena for someone’s medical information.
In response to a question by Representative Marzian, Dr. Brenzel stated that there are many unnecessary duplicative tests performed on the same patient.
In response to a question by Representative Adams, Ms. Bentley stated that Kentucky’s health information exchange is in the top five percent of states with an exchange. KHIE is a comprehensive system that has the capability to track health trends. KHIE has begun work with West Virginia, Indiana, and Missouri on interstate interoperability, and hope to begin work with Tennessee and Virginia soon.
In response to questions by Representative DeWeese, Ms. Bentley stated that all acute care hospitals have signed participation agreements and 65 percent are on line and technical teams are working to get the remainder on line. Ninety percent of qualified health care clinics have signed participation agreements and approximately 70 percent are on line. Eighty percent of rural health clinics are on line. Providers can connect to KHIE to get information from other providers instead of having to connect to all providers for the information. Dr. Brenzel stated that only two of the fourteen regional mental health center boards contribute information to KHIE. Behavioral health providers were not incentivized initially to use electronic health records.
In response to questions by Senator Givens, Ms. Bentley stated that patients own their own health data. Ms. Chrisman stated that according to HIPAA, patients’ medical records are providers’ business records of patients’ visits, and patients have the right to access their medical record. The medical record is not for a patient’s use but a record for the provider to help provide medical treatment. Under HIPAA, a provider is allowed to use the medical information for treatment, operations, and payment. The Notice of Privacy a patient receives in a provider’s office tells what will be done with a patient’s medical information. Under HIPAA, a patient has the right to request that information be restricted from disclosure, but a provider does not have to honor the restriction. It is a HIPAA violation for a provider to query information from KHIE for someone who is not a patient, and a provider can lose his license. An administrative regulation accepts the participation agreement as the only way a provider can become part of the KHIE. In the participation agreement, Medicaid providers are specifically limited even farther than treatment, payment, and operations in the way they can use the KHIE. KHIE can only be used for care coordination to provide care for a Medicaid patient.
In response to a question by Representative Burch, Ms. Bentley stated that dentists are included in the incentives and will be a part of KHIE.
Early Childhood Advisory Council
Elizabeth Whitehouse, Deputy Executive Director, Governor's Office of Early Childhood; Brigitte Blom Ramsey, Kentucky Early Childhood Advisory Council and United Way of Greater Cincinnati/Northern Kentucky, stated that a $45 million grant application, Race to the Top Early Learning Challenge was submitted and accepted. Early childhood investments pay dividends for the life of the child. Each dollar invested returns $60 to $300 over a child’s lifetime. The Perry Preschool Project, and Abecedarian Project reports that children that were enrolled in a quality early childhood education program earn $2,000 more per month than peers, more likely to graduate high school, more likely to own a home, less likely to repeat grades, less likely to need special education, and less likely to be incarcerated. C.A. Nelson from Neurons to Neighborhoods, 2000 reports that 85 percent of brain development occurs before age five. Kentucky Invests in Developing Success (KEIS) created the Early Childhood Development Authority.
In 2000, twenty-five percent of tobacco settlement funds were committed to early childhood through the KIDS NOW programs. The tobacco settlement funds have decreased from $28.8 million in 2000 to $21.1 million in 2013 which means a 27 percent decrease in program funding. KIDS NOW programs include vision screening, reach out and read, universal children’s immunizations, KEIS/First Steps, folic acid program, Healthy Start Program, hearing screening, early childhood oral health, substance abuse treatment program, early childhood scholarship program, early childhood mental health, child care program, Healthy Access Nurturing Development Services (HANDS) Program, and child advocacy centers. In 2011, The Early Childhood Advisory Council was created to promote program accountability and provide guidance that affects Kentucky children and families. The school readiness definition that was created by the Governor’s Task Force on Early Childhood Development and Education means that each child enters school ready to engage in and benefit from early learning experiences that best promote the child’s success and ability to be ready to grown, learn, and succeed. Kentucky screens kindergarteners to make informed decisions about early childhood systems, identify statewide and local challenges, mobilize communities, communicate results, demonstrate return on investment, and encourage continuous improvement. The five domains of school readiness are general knowledge and mathematics, health and physical well-being, approaches to learning, language and communication development, and social and emotional development. Quality is very important in day care centers. A goal is to increase participation in the STARS program.
Representative Benvenuti and Representative Palumbo stated that Kentucky’s focus should be on kids instead of entitlement programs.
In response to a question by Senator Bowen, Ms. Ramsey stated that information is distributed at grocery stores, libraries, pediatrician offices, health department, and neighborhood programs. In early spring 2012, the Governor’s Office of Early Childhood requested that all community early childhood councils to conduct a needs assessment to find out what children were and were not accessing programs within each county. There is a community early childhood council in 109 of the 120 counties.
Representative Wuchner stated that Boone County received the first early childhood learning grant for $3.25 million.
In response to questions by Senator Givens, Ms. Whitehouse stated that screening is a communication tool but does not say that one center is preparing children better than another center. Ms. Ramsey stated she wants to ensure that the quality of programs is as high as possible and that public dollars are used on quality services to take children where they need to go for success. Private childcare providers can receive state subsidies for children who qualify for services. The quality rating system is voluntary.
In response to a question by Representative Jenkins, Ms. Ramsey stated that the goal is for early childhood councils to find partners to help ensure access and support to families.
Donated Dental Services
Larry Coffee, DDS, Founder and CEO, Dental Lifeline Network, stated that Donated Dental Services (DDS) is an efficient, cost effective, and accountable community-based and person-centered approach to advancing the health and well-being of needy disabled, elderly, and medically-compromised individuals by providing comprehensive pro bono dental care through a network of volunteer dentists and laboratories. An investment of $70,000 by the Commonwealth to mobilize approximately 275 volunteer dentists and 25 laboratories will return up to $550,000 in comprehensive pro bono therapies for approximately 250 individuals annually. The investment will yield additional healthcare savings since priority is given to people whose dental condition, in combination with other diseases, create risk of costly complications. The people DDS serve have health problems, developmental disabilities, serious and persistent mental illnesses, functional limitations related to advanced age, physical and or sensory impairments, and some veterans unable to obtain dental care through the Veterans Administration.
Volunteer dentists fully donate their services, including the use of their offices and supplies. General practitioners, specialists, and laboratories participate so patients receive comprehensive and sustainable care rather than limited treatment. Many patients will be treated by specialists in addition to a general dentist. Implants, gold casting alloys, and other specialized materials are donated by manufacturers as needed. The social work coordinator is responsible for distributing materials about DDS to individuals requesting assistance, determining general eligibility of applicants, arranging referrals to volunteers, involve laboratories as needed, and assuring that the needs of patients and volunteers are resolved throughout the course of treatment. Approximately 120,000 individuals throughout the country have received over $250 million of comprehensive treatment from 15,200 dentists and 3,300 laboratories. Dental Lifeline Network, a charitable affiliate of the American Dental Association, began DDS as a small pilot in the late 1980s. Most activity is concentrated in 41 state-specific programs with some of them be supported by state governments.
Discussion of 201 KAR 20:400
Paula Schenk, Executive Director, Kentucky Board of Nursing, stated that on July 13, 201 KAR 20:400 was amended at the Administrative Regulations Review Subcommittee (ARRS). At the August 21, 2013 Kentucky Board of Nursing (KBN) regular meeting, the amendments to administrative regulation were reviewed and the board directed that it be withdrawn for consideration at the August 21, 2013 Interim Joint Committee on Health and Welfare meeting. One reason for withdrawal by the board was that a school personnel training course should be developed and integrated into the administrative regulation before it goes into effect. The initial filing of 902 KAR 20:400 only referenced the development of a course which would have to be completed later. The board directed that the nursing delegation of administration of insulin in a school setting be placed in a separate regulation and that a panel of experts be convened to identify content and development modules of the training curriculum for the administration of insulin and glucagon to students in a school setting. The group of experts have met and are in the process of writing the instructional modules to be included in the training program. In addition, the board directed that a workgroup of stakeholders and interested parties be convened to review the draft curriculum. The workgroup will serve in an advisory capacity and provide the working recommendations to the KBN Practice Committee. On November 14, 2013 the KBN Practice Committee will convene to review the draft recommendation. The goal is to have this work completed and presented to the board for approval at its December 13, 2013 regular meeting. If approved by the Governor, the KBN will file the emergency and ordinary administrative regulations with the Legislative Research Commission. This would allow the schools the spring and summer of 2014 to implement and conduct the training in preparation for the new school year. The board’s mission is to protect the public and hope the regulation will provide the needed protection and assistance for the children of Kentucky who live with diabetes.
In response to questions by Representative Lee, Ms. Schenk stated that the emergency administrative regulation will have only language that applies to a school setting. The plan is to promulgate a separate administrative regulation addressing only the delegation of administration of insulin and glucagon in a school setting and the modules and training for the school personnel. The emergency administrative regulation will be identical to the ordinary administrative regulation.
Bob Babbage representing the American Diabetes Association stated that the KBN has a responsibility not only to nurses but legislators. The KBN has known for three years that the insulin administrative regulations needed to be reviewed. If the board develops a curriculum that exceeds the one used in 22 states that use the American Diabetes Association training and preparation module, it becomes very difficult to volunteer, qualify, and participate.
Lori Bradley, parent, stated that her son Brandon has been diagnosed with Type 1 diabetes, and if his blood sugar levels drop he needs an insulin injection immediately. High or low blood sugar levels are unpredictable, and there needs to be someone available all day at the schools to help give injections when necessary to control the levels. She questioned what would happen to kids who do not or will not give themselves a shot when needed and there is no one available to help. Children living with Type 1 diabetes often times feel different enough without having to force them to stand out even more than necessary. Parents risk their jobs when they have to leave work to go to the school to help their child manage diabetes or give a shot that could have been handled by any other individual that was trained and willing. The safety of the children is a priority. Volunteers must be trained to assist kids with Type 1 diabetes management during the day.
In response to a question by Representative Adams, Stewart Perry, State Advocacy Volunteer Chair, American Diabetes Association, stated that there is no liability for school districts, because the statutes already cover liability. Mr. Babbage stated that there were no objections to the amended administrative regulation at the July ARRS meeting.
Representative Benvenuti stated that private schools do not always have budgets for a school nurse, and proper training is needed for volunteers as soon as possible.
In response to a question by Representative Wuchner, Mr. Perry stated that if a public school receives federal dollars, Section 504 of the American Disabilities Act applies to a child in school. Most children with diabetes file a 504 plan with the school that is developed with the doctor, nurses, and educators that the child sees and helps identify who and when a child can be helped. Currently Kentucky has a rule on the books that only a medical professional can administer insulin in a school setting.
In response to questions by Representative Owens, Ms. Schenk stated that the KBN is in the process of developing a training curriculum for school personnel who volunteer to administer injectable insulin and glucagon to students in a school setting. The American Diabetes Association training module is being considered by the KBN in the development of the training curriculum modules. There some specific things that the content experts may want to include that would enhance the information in the training curriculum. The KBN Practice Committee would want assurance that the unlicensed person performing the act is safe and competent at calculating carbohydrates and to administer medication. Mr. Perry stated the training modules that exist were done by the American Diabetes Association in conjunction with the national diabetes education project.
In response to a question by Senator Denton, Mr. Perry stated that he did not know of any other states that do not use the American Diabetes Association training module curriculum, but he would check and let her know. Ms. Schenk stated that the KBN takes its responsibility to ensure that the delegation of the administration of insulin to children by school personnel who do not have the nursing knowledge and judgment. The board does not intend to create unnecessary impediments or barriers.
In response to questions by Representative Westrom, Mr. Perry stated that in 2013, the KBN and the American Diabetes Association negotiated an administrative regulation instead of trying to get a law passed regarding a training module curriculum. No information was provided by the KBN as to why the administrative regulation was pulled at the August 21, 2013 meeting of the Interim Joint Committee on Health and Welfare. Ms. Schenk stated that. On August 21, 2013, the KBN meeting occurred at the same time as the interim joint committee; therefore, did not have time to contact anyone about its decision to withdraw the administrative regulation. The board approved 201 KAR 20:40 at its June meeting and it went through the public comment period and was scheduled to be heard at the July 13, 2013 ARRS meeting where it was amended. Since the board did not meet again until August 21, 2013, there was no time for the board to consider the amendment. The board expressed its belief that the training program for school personnel should be developed and incorporated into the administrative regulation as opposed to its original filing where it was only mentioned that the board would develop a course. The board felt that it would be better in terms of quality to have the components of the training curriculum outlined and in the administrative regulation rather than waiting for it to be developed after the administrative regulation went into effect. The board wants to be thorough in its evaluation of all resources and to prepare a program that will sufficiently train and verify the competence of the unlicensed person to perform the injections in a school setting so the child is safe.
In response to questions by Representative Watkins, Ms. Schenk stated that Representative Jimmie Lee offered the amendment at the ARRS meeting, and the staff and board vice president agreed to the amendment, but it was not reviewed by the entire board until the August board meeting. The board did not object to the amendment. Representative Lee stated that the KBN has to approve any amendment to an administrative regulation, and the amendment did not include the curriculum training. The training curriculum could have been included in the administrative regulation by reference, but the board did not elect to put the training curriculum in by reference.
In response to questions by Representative Wuchner, Ms. Schenk stated that the draft would be sent to all interested people before the December meeting for review to make comments and suggestions.
Kentucky’s Food Banks
Tamara Sandberg, Executive Director, Kentucky Association of Food Banks, stated that there is more than enough food in America to feed every man, woman, and child, yet in Kentucky approximately 750,000 people face hunger. Hunger, which was once considered a problem for very low-wage earners, is now a problem for people from all walks of life. Many people live one paycheck away from financial disaster. An unexpected illness, injury, car repair, or life change can put a self-sufficient person at risk of hunger. Children who experience hunger face significant stress and challenges that can have a lasting effect on their physical, cognitive, and behavioral development. Child who experience hunger come to school ill-prepared to learn, are more likely to have trouble focusing in class, and may struggle with complex social interactions and adapt less effectively to environmental stress. The elderly face a number of medical and mobility challenges that put them at greater risk of hunger. The senior population may require different interventions that take into account health status, medication needs, transportation, physical limitations, and dietary restrictions. Seniors living on fixed incomes often have to choose between covering the cost of life-saving medications and buying the food they need to stay healthy. It will cost the Commonwealth more in the long-term to continue to allow so many of its citizens go to bed hungry each night.
The Kentucky Association of Food Banks is comprised of seven Feeding America food bans that serve all 120 counties in Kentucky in partnership with over 1,000 local charitable feeding organizations. The association and its partners secure and provide food for families struggling with hunger, educate the public about the problem of hunger, and advocate for legislation that protects people from going hungry. A food bank is a distribution center and a food pantry is a local agency. Partners across manufacturing, retail, growing, and shipping industries donate food such as fresh produce, meat, grains, and dairy as well as frozen and canned foods, grocery items for people struggling to put food on the table. We all have a role to play in making sure every family has enough to eat. Approximately 52.9 million pounds of food and grocery products are distributed through agencies, mobile pantries, the BackPack Program, Kids Café programs, the Summer Food Program, and the School Based Pantry Program. Less than one percent of donated produce came from Kentucky farms.
According to the Feeding America’s Hunger’s New Staple data, food pantries have gone from being a temporary source for emergency food assistance to a regular source of food for hungry families. The Beef Counts KY program was established and endorsed by the Kentucky Beef Council to provide a consistent supply of nutrient-rich beef for people facing hunger in Kentucky. Participating farmers donate proceeds from the sale of beef animal to the Beef Counts KY program. Proceeds from the sale of one animal should provide 1,600 services of high-quality nutrient-rich beef protein. Every year the United States wastes more than six billion pounds of fresh, healthy fruits and vegetables. Families with limited resources are often forced to purchase low-cost foods that are loaded with calories, but have little to no nutritional value in order to stretch the grocery budgets further. For low-income families in impoverished communities, there are few options for health food purchases. Studies have shown that when food is scarce, a person’s body adapts by retaining more weight. Parents and caregivers with small children are often victims of this type of weight gain in order for their children to have enough to eat.
In 2009, legislation was enacted to create a Farms to Food Banks grant program within the Kentucky Department of Agriculture. Currently, there has been no funding for the grant program, but the Kentucky Association of Food Banks has implemented the program using other funds. Starting in 2014, individuals can donate a portion of their tax refund to the Farms to Food Banks Trust Fund administered by the Kentucky Department of Agriculture. Thirty-eight other states provide support for food banks from the General Fund. A well-fed population will save the Commonwealth more in the long run through reduced healthcare costs, increased educational performance, and enhanced worker productivity.
In response to questions by Representative Burch, Ms. Sandberg stated that starting in 2014 individuals can donate a portion of their tax refund to the Farms to Food Banks Trust Fund administered by the Kentucky Department of Agriculture. The trust fund was established to award grants to nonprofit organizations for the purpose of purchasing surplus agricultural commodities or culls at production cost and distributing it to hungry Kentuckians through feeding programs. Forty-one percent of Kentuckians earn too much money to qualify for food assistance.
In response to a question by Senator Clark, Ms. Sandberg stated that the food banks need $500,000 yearly to operate.
Adjournment
There being no further business, the meeting was adjourned at 4:13 p.m.